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K Bullock

Publications and source records attributed to K Bullock.

18 recordsLinked to original sources
PubMed1999

Herbal remedies.

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Bradycardia↗
PubMed1999

Dental care of patients with substance abuse.

Patients who abuse alcohol, crack, heroin or prescription drugs, are likely to interact with the dental professional. The dentist should therefore be able to identify problems of abuse and provide informed care and referral. Substance abuse should be a consideration in all patients who present with dental trauma and those who present with frequent vague complaints, multiple pain medication allergies, and regimens with multiple narcotic medications. Polydrug use, either prescription or illicit, is also a possibility, and effective treatment requires prompt recognition. Dentists should be alert to drug-seeking behavior within the context of pain management, and because pain severity is an objective experience, each patient must be treated carefully and sensitively. Unrelieved or unremitting pain can be a relapse trigger and therefore adequate pain control is a necessity in the recovering chemically dependent patient. New modalities, such as coanalgesia with low-dose ketamine in the opioid addicted have been shown to work effectively. In the post-dental surgical patient with chemical dependency, agents with less psychoactive activity than their drugs of abuse, such as extended-release morphine (MS Contin) have been tried with variable success. An informed treatment plan includes recognition of substance abuse, appropriate intervention, and referral. This plan may include universal screening, followed by brief interventional therapy for positive patients and in some cases, pharmacological pain control. On discharge from the office, instructions concerning referral to a substance abuse program or, in the case of the patient who may require more immediate treatment, to the emergency department are important.

Alcoholism↗
PubMed1997

Understanding the variability in the effectiveness of community heart health programs: a meta-analysis.

Over the past 25 years, community interventions to reduce cardiovascular disease (CVD) have been conducted around the world with very mixed results. This study uses meta-analysis to assess whether the variation in the observed effectiveness of community heart health programs (CHHP) is related to characteristics of the intervention program, the population under study, or the evaluation methods. A CHHP is defined as any primary prevention program that attempted to reduce the population burden of CVD by shifting the distribution of risk factors in a general population. To be included in the meta-analysis, a study must have utilized a reference group in the evaluation, employed a repeated independent cross-sectional measurement design, and reported sufficient outcome information for at least one of four major risk factors: smoking, total cholesterol, blood pressure, and body weight. Results of these studies are summarized with the effect size measure (Yi1-Yi2)-(Yr1-Yr2)Sr1 where Y = outcome measure, S = standard deviation of the outcome measure, 1 = baseline, 2 = follow-up. i = intervention, and r = reference community. This measure, which reports the net change in the intervention group in terms of the variability in the reference population before the start of the intervention, permits comparison across different outcome measures and facilitates the aggregation of effects across studies. Generalized least squares regression, which permits the incorporation of multiple, dependent effect sizes from a single study, was used to assess the impact of characteristics of the intervention (prevention strategy, type of mass communication, community organization, and environmental change), the population (setting, gender, year of follow-up measurement), and the evaluation design and implementation (the number of communities, matching of communities, the follow-up time, the response rate, and covariate adjustment in the analysis) on the effect sizes. The results of this analysis suggest that the characteristics of the evaluation method account for much of the heterogeneity in the outcome of CHHPs, though some intervention characteristics also play a role.

Blood Pressure↗
PubMed1997

Medical renaissance.

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Complementary Therapies↗
PubMed1982

Swift increase in alcohol metabolism (SIAM) in the mouse: comparison of the effect of short-term ethanol treatment on ethanol elimination in four inbred strains.

Ethanol metabolism increases 2 to 3 hr after the administration of ethanol. This phenomenon, called the swift increase in alcohol metabolism, has been compared in four inbred strains of mice (DBA/2J, C3H/HeJ, AKR/J and C57BL/6J). Basal rates of ethanol elimination were determined in individual mice after an i.p. injection of ethanol (2 g/kg). Little variability in this basal rate of ethanol elimination was observed within each strain. Mice were then exposed to ethanol vapor (20--22 mg/l) and rates of ethanol elimination were determined every 2 hr for 8 hr. By 2 to 3 hr, the rates of ethanol elimination initially increased 2- to 3-fold and then declined toward basal rates over the 8-hr interval in all strains studied. In another experiment, the dose of ethanol was varied to produce blood ethanol levels ranging from 50 to 250 mg/100 ml in both basal- and ethanol vapor-treated mice. Ethanol elimination increased greater than 1.5-fold in all four strains studied when basal rates were compared to rates observed after 4 hr of vapor treatment at the same blood ethanol level; however, the dose at which the maximal increase occurred differed among the strains. DBA/2J mice exhibited a maximal increase in the rate of ethanol elimination when ethanol concentrations were in the range of 30 to 50 mg/100 ml; the increase was smaller as the dose was increased. In contrast, AKR/J and C57BL/6J mice required 100 to 150 mg/100 ml of ethanol to activate the swift increase in alcohol metabolism effect. These data indicate clearly that the swift increase in alcohol metabolism effect is a common phenomenon and that dose and time relations differ in various inbred strains of mice.

Animals↗